The economic and healthcare impacts of COVID-19 on adolescents with autism

The COVID-19 pandemic has placed massive social and economic burdens on the lives of children with autism spectrum disorder (ASD) and their families. Minoritized and low-income children and their families bear a disproportionately higher brunt of the pandemic and face a greater risk of economic hardship poor mental health and limited access to healthcare. The roots of these inequities are shaped by social determinants of health (SDoH) and understanding and acting on those determinants can play a pivotal role in advancing health equity for children and teenagers with autism Goal(s) and objectives. The central goal is to assess the economic and healthcare impacts of COVID-19 among youth and young adults with ASD and to consider context-specific effects based on race/ethnicity and income. Aligning with Healthy People 2030�s vision the study aims to: 1) Identify the prevalence determinants and context of economic insecurity during COVID-19 among ASD households; 2) Examine changes in economic insecurity and access to healthcare among youth with autism before and during COVID-19 and context-specific effects (e.g. race and ethnicity household income); and 3) Identify economic profiles associated with healthcare access among youth with autism during COVID-19. Proposed data sets and target population. The study draws from the Families and Child Wellbeing Study the National Emergency Department Sample and the National Survey of Children�s Health. Our sample comprises of youth and young adults with autism 3-25 years. To address Aim 1 we will produce population-level estimates of economic insecurity among ASD households and compare them to those of children with other disabilities. To address Aim 2 we will calculate levels of material hardship among ASD households during the pandemic (2020-2022) and compare them to pre-COVID levels (2017-2019). The study will also use national claims data to determine whether the number of emergency department visits increased during COVID for people with autism ages 3-25 years and if reasons for visits differed over time. The final set of analyses will use latent class analysis to create profiles of economic insecurity among ASD households and their relationship to healthcare access.